الفهرس 
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Abstract
K. pneumoniae is an extremely resilient bacterium which poses many virulence factors as the capsule , lipopolysaccharide (LPS) , siderophores and fimbriae allowing it to attack and persist in hosts.
K. pneumoniae infections are divided into two main categories: community-acquired and hospital-acquired.
The emergence and spread of carbapenem and cephalosporin resistant strains of K. pneumonia are a considerable threat to public health because of the growing circulation of MDR K. pneumoniae.
Infections with multidrug resistant Klebsiella pneumonia are widespread in developed and developing countries with a poor prognosis, high mortality rate and high associated economic costs.
The primary aim of the study was to detect the incidence and the nature of Klebsiella infections in Alexandria University Pediatric Intensive Care Unit, detect the most common resistant genes with Klebsiella using the PCR multiplex.
Out of 246 patients admitted to PICU during the study period (first of July 2019 to the end of June 2020), 44 patients had positive cultures for Klebsiella.
Out of the 44 cases, 37 patients (84.1%) had multidrug resistant (MDR) Klebsiella spp. isolates, while seven patients (15.9%) harbored extensive drug (XDR) isolates. Comparison of the extent of drug resistance between discharged and deceased groups proved that 6 out of 7 patients having XDR isolates died, while 26 out of 37 patients with MDR isolates were discharged.
The most common resistant gene detected with Klebsiella infection was found to be NDM gene followed by CTX-M gene.
In univariate analysis of mortality risk factors; PIM2, PELOD scores, LOS, XDR were associated with significant risk of mortality in the 44 patients. After adjusting all confounders, only PELOD score and XDR were considered a significant risk for mortality with an odds ratio of 2.4 and 139.5 respectively.